ELG.021.251

MSIS-IDENTIFICATION-NUM

Data Element

DE Number

ELG251

System DE Number

ELG.021.251

File Name

ELG - ELIGIBLE

File Segment Number

ELG00021

File Segment Name

ENROLLMENT-TIME-SPAN-SEGMENT

Last updated

Overview Valid Values Related Rules Related DQ Measures Other Instances

Definition	A state-assigned unique identification number used to identify a Medicaid/CHIP enrolled individual (except on service tracking payments). Value may be an SSN, temporary SSN or State-assigned eligible individual identifier. MSIS Identification Numbers are a unique "key" value used to maintain referential integrity of data distributed over multiples files, segments and reporting periods. See T-MSIS Guidance Document, "CMS Guidance: Reporting Shared MSIS Identification Numbers" for information on reporting the MSIS Identification Numbers ID for pregnant women, unborn children, mothers, and their deemed newborns younger than 1 year of age who share the same MSIS Identification Number. https://www.medicaid.gov/medicaid/data-and-systems/macbis/tmsis/tmsis-blog/entry/47572
Size	X(20)
FLF Start Position	22
FLF Stop Position	41
Segment Key Field Identifier	2
Coding Requirements	1. Mandatory 2. Value must be 20 characters or less

Valid Value Code Set	Valid Value Code	Valid Value Name	Valid Value Description	Effective Start Date	Effective End Date

RULE ID	RULE Definition
RULE-6203	If a segment is an enrollment time span segment segment from an ELG file, the MSIS identification number value reported must be compatible with the specified T-MSIS picture format: X(20).
RULE-7191	If enrollment type is for Medicaid or Medicaid expansion CHIP on an enrollment time span segment from an ELG file, then the effective date and end date on the enrollment time span segment must fall within the effective and end dates of one or more continuous variable demographics eligibility segments and the CHIP code must be for Medicaid or Medicaid expansion CHIP on the variable demographic eligibility segment.
RULE-7192	If enrollment type is for S-CHIP on an enrollment time span segment from an ELG file, then the effective date and end date on the enrollment time span segment must fall within the effective and end dates of one or more continuous variable demographics eligibility segments and the CHIP code must be for S-CHIP on the variable demographic eligibility segment.
RULE-7247
RULE-7531	If the MSIS ID is populated on an enrollment time span segment from an ELG file, and the eligible contact information segment matches on join keys then the eligible contact information address type is equal to the primary home address.
RULE-7538	If MSIS ID is populated on an enrollment time span segment from an ELG file, then the effective date and end date on the enrollment time span segment must fall within the effective and end dates of one or more continuous primary demographics eligibility segments and the MSIS ID is populated in the primary demographics eligibility segment.
RULE-7539	If MSIS ID is populated on an enrollment time span segment from an ELG file, then the effective date and end date on the enrollment time span segment must fall within the effective and end dates of one or more continuous variable demographics eligibility segments and the MSIS ID is populated in the variable demographics eligibility segment.
RULE-7540	If MSIS ID is populated on an enrollment time span segment from an ELG file, then the effective date and end date on the enrollment time span segment must fall within the effective and end dates of one or more continuous eligibility determinants segments and the MSIS ID is populated in the eligibility determinants segment.
RULE-2513	All enrollment time span segments must have a corresponding primary demographics eligibility segment where the enrollment time span effective and end dates are within the primary demographics eligibility effective and end dates. Note: Primary demographics eligibility dates can be consecutive or overlapping.

Measure ID	Measure Name
MCR-31-002-2	% of MSIS IDs enrolled on Beginning Date of Service
RULE-1337	% of claim headers with an MSIS ID not enrolled on Beginning Date of Service
MCR-31-010-10	% of MSIS IDs enrolled on Prescription Fill Date
MCR-31-009-9	% of MSIS IDs enrolled on Beginning Date of Service
MCR-31-008-8	% of MSIS IDs enrolled on Beginning Date of Service
MCR-31-007-7	% of MSIS IDs enrolled on Beginning Date of Service
MCR-31-006-6	% of MSIS IDs enrolled on Admission Date
MCR-31-005-5	% of MSIS IDs enrolled on Prescription Fill Date
MCR-31-004-4	% of MSIS IDs enrolled on Beginning Date of Service
MCR-31-003-3	% of MSIS IDs enrolled on Beginning Date of Service
RULE-1758	% of claim headers with an MSIS ID not enrolled on Prescription Fill Date
MCR-31-001-1	% of MSIS IDs enrolled on Admission Date
MCR-30-010-10	% of MSIS IDs with any enrollment time span
MCR-30-009-9	% of MSIS IDs with any enrollment time span
MCR-30-008-8	% of MSIS IDs with any enrollment time span
MCR-30-007-7	% of MSIS IDs with any enrollment time span
MCR-30-006-6	% of MSIS IDs with any enrollment time span
MCR-30-005-5	% of MSIS IDs with any enrollment time span
MCR-30-004-4	% of MSIS IDs with any enrollment time span
ALL-13-003-3	% of MSIS IDs with alien restricted benefits code status (RESTRICTED-BENEFITS-CODE = 2) with non-emergency room services
EL-6-041-41	% of MSIS IDs enrolled in the past year with at least three gaps in enrollment over that time
EL-6-040-40	% of MSIS IDs enrolled in the past year with at least one gap in enrollment over that time
RULE-7247	% of ELG00021 record segments with a missing MSIS ID
RULE-7540	% of segments reported on ENROLLMENT-TIME-SPAN-SEGMENT-ELG00021 that are not found on ELIGIBLITY-DETERMINANTS-ELG00005 for the same month
RULE-7539	% of segments reported on ENROLLMENT-TIME-SPAN-SEGMENT-ELG00021 that are not found on VARIABLE-DEMOGRAPHICS-ELIGIBILITY-ELG00003 for the same month
RULE-7538	% of segments reported on ENROLLMENT-TIME-SPAN-SEGMENT-ELG00021 that are not found on PRIMARY-DEMOGRAPHICS-ELIGIBILITY-ELG00002 for the same month
ALL-13-004-6	% of MSIS IDs with alien restricted benefits code status (RESTRICTED-BENEFITS-CODE = 2) with services that are not emergency room or pregnancy-related
ALL-13-004-4	% of MSIS IDs with alien restricted benefits code status (RESTRICTED-BENEFITS-CODE = 2) with non-emergency room services
MCR-30-003-3	% of MSIS IDs with any enrollment time span
RULE-7646	% of claim headers with an MSIS ID not enrolled on Beginning Date of Service
RULE-7645	% of claim headers with an MSIS ID not enrolled on Prescription Fill Date
RULE-7644	% of claim headers with an MSIS ID not enrolled on Beginning Date of Service
RULE-7643	% of claim headers with an MSIS ID not enrolled on Beginning Date of Service
RULE-7642	% of claim headers with an MSIS ID not enrolled on Admission Date
TPL-1-005-5	% of MSIS IDs with any enrollment time span
RULE-884	% of claim headers with an MSIS ID not enrolled on Beginning Date of Service
RULE-335	% of claim headers with an MSIS ID not enrolled on Admission Date
ALL-14-007-7	% of MSIS IDs on crossover claim headers enrolled as premium only dual groups (SLMB, QI, QDWI) on Beginning Date of Service
EXP-45-006-6	% of MSIS IDs with any enrollment time span
EXP-45-005-5	% of MSIS IDs with any enrollment time span
EXP-45-004-4	% of MSIS IDs with any enrollment time span
EL-19-001-1	% of MSIS IDs enrolled any day in the previous month but not any day in the current month, with missing, invalid, unknown, or other ELIGIBILITY-CHANGE-REASON
EL-17-003-3	% of MSIS IDs reported on ENROLLMENT-TIME-SPAN-SEGMENT-ELG00021 that are not found on ELIGIBLITY-DETERMINANTS-ELG00005 for the same month
EL-17-002-2	% of MSIS IDs reported on ENROLLMENT-TIME-SPAN-SEGMENT-ELG00021 that are not found on VARIABLE-DEMOGRAPHICS-ELIGIBILITY-ELG00003 for the same month
EL-17-001-1	% of MSIS IDs reported on ENROLLMENT-TIME-SPAN-SEGMENT-ELG00021 that are not found on PRIMARY-DEMOGRAPHICS-ELIGIBILITY-ELG00002 for the same month
EL-16-009-9	% of ELG00021 record segments with a missing MSIS ID
ALL-14-008-8	% of MSIS IDs on crossover claim headers enrolled as premium only dual groups (SLMB, QI, QDWI) on Prescription Fill Date
FFS-24-001-1	% of MSIS IDs with any enrollment time span
ALL-14-006-6	% of MSIS IDs on crossover claim headers enrolled as premium only dual groups (SLMB, QI, QDWI) on Beginning Date of Service
ALL-14-005-5	% of MSIS IDs on crossover claim headers enrolled as premium only dual groups (SLMB, QI, QDWI) on Admission Date
ALL-14-004-4	% of MSIS IDs on crossover claim headers not enrolled as duals (QMB, QMB Plus, SLMB Plus, Other) on Prescription Fill Date
ALL-14-003-3	% of MSIS IDs on crossover claim headers not enrolled as duals (QMB, QMB Plus, SLMB Plus, Other) on Beginning Date of Service
ALL-14-002-2	% of MSIS IDs on crossover claim headers not enrolled as duals (QMB, QMB Plus, SLMB Plus, Other) on Beginning Date of Service
ALL-14-001-1	% of MSIS IDs on crossover claim headers not enrolled as duals (QMB, QMB Plus, SLMB Plus, Other) on Admission Date
ALL-13-003-5	% of MSIS IDs with alien restricted benefits code status (RESTRICTED-BENEFITS-CODE = 2) with services that are not emergency room or pregnancy-related
ALL-13-002-2	% of MSIS IDs limited to family planning (RESTRICTED-BENEFITS-CODE = 6) with non-family planning services (PROGRAM-TYPE not equal 2)
FFS-25-002-2	% of MSIS IDs enrolled on Beginning Date of Service
MCR-30-002-2	% of MSIS IDs with any enrollment time span
MCR-30-001-1	% of MSIS IDs with any enrollment time span
FFS-25-008-8	% of MSIS IDs enrolled on Prescription Fill Date
FFS-25-007-7	% of MSIS IDs enrolled on Beginning Date of Service
FFS-25-006-6	% of MSIS IDs enrolled on Beginning Date of Service
FFS-25-005-5	% of MSIS IDs enrolled on Admission Date
FFS-25-004-4	% of MSIS IDs enrolled on Prescription Fill Date
FFS-25-003-3	% of MSIS IDs enrolled on Beginning Date of Service
ALL-13-001-1	% of MSIS IDs limited to family planning (RESTRICTED-BENEFITS-CODE = 6) with non-family planning services (PROGRAM-TYPE not equal 2)
FFS-25-001-1	% of MSIS IDs enrolled on Admission Date
FFS-24-008-8	% of MSIS IDs with any enrollment time span
FFS-24-007-7	% of MSIS IDs with any enrollment time span
FFS-24-006-6	% of MSIS IDs with any enrollment time span
FFS-24-005-5	% of MSIS IDs with any enrollment time span
FFS-24-004-4	% of MSIS IDs with any enrollment time span
FFS-24-003-3	% of MSIS IDs with any enrollment time span
FFS-24-002-2	% of MSIS IDs with any enrollment time span

DE Number	System DE Number	DE Name	File Segment Number	File Segment Name
CIP022	CIP.002.022	MSIS-IDENTIFICATION-NUM	CIP00002	CLAIM-HEADER-RECORD-IP
CIP234	CIP.003.234	MSIS-IDENTIFICATION-NUM	CIP00003	CLAIM-LINE-RECORD-IP
CLT022	CLT.002.022	MSIS-IDENTIFICATION-NUM	CLT00002	CLAIM-HEADER-RECORD-LT
CLT187	CLT.003.187	MSIS-IDENTIFICATION-NUM	CLT00003	CLAIM-LINE-RECORD-LT
COT022	COT.002.022	MSIS-IDENTIFICATION-NUM	COT00002	CLAIM-HEADER-RECORD-OT
COT157	COT.003.157	MSIS-IDENTIFICATION-NUM	COT00003	CLAIM-LINE-RECORD-OT
CRX022	CRX.002.022	MSIS-IDENTIFICATION-NUM	CRX00002	CLAIM-HEADER-RECORD-RX
CRX111	CRX.003.111	MSIS-IDENTIFICATION-NUM	CRX00003	CLAIM-LINE-RECORD-RX
ELG019	ELG.002.019	MSIS-IDENTIFICATION-NUM	ELG00002	PRIMARY-DEMOGRAPHICS-ELIGIBILITY
ELG033	ELG.003.033	MSIS-IDENTIFICATION-NUM	ELG00003	VARIABLE-DEMOGRAPHICS-ELIGIBILITY
ELG064	ELG.004.064	MSIS-IDENTIFICATION-NUM	ELG00004	ELIGIBLE-CONTACT-INFORMATION
ELG082	ELG.005.082	MSIS-IDENTIFICATION-NUM	ELG00005	ELIGIBILITY-DETERMINANTS
ELG106	ELG.006.106	MSIS-IDENTIFICATION-NUM	ELG00006	HEALTH-HOME-SPA-PARTICIPATION-INFORMATION
ELG117	ELG.007.117	MSIS-IDENTIFICATION-NUM	ELG00007	HEALTH-HOME-SPA-PROVIDERS
ELG129	ELG.008.129	MSIS-IDENTIFICATION-NUM	ELG00008	HEALTH-HOME-CHRONIC-CONDITIONS
ELG139	ELG.009.139	MSIS-IDENTIFICATION-NUM	ELG00009	LOCK-IN-INFORMATION
ELG149	ELG.010.149	MSIS-IDENTIFICATION-NUM	ELG00010	MFP-INFORMATION
ELG162	ELG.011.162	MSIS-IDENTIFICATION-NUM	ELG00011	STATE-PLAN-OPTION-PARTICIPATION
ELG171	ELG.012.171	MSIS-IDENTIFICATION-NUM	ELG00012	WAIVER-PARTICIPATION
ELG181	ELG.013.181	MSIS-IDENTIFICATION-NUM	ELG00013	LTSS-PARTICIPATION
ELG191	ELG.014.191	MSIS-IDENTIFICATION-NUM	ELG00014	MANAGED-CARE-PARTICIPATION
ELG203	ELG.015.203	MSIS-IDENTIFICATION-NUM	ELG00015	ETHNICITY-INFORMATION
ELG212	ELG.016.212	MSIS-IDENTIFICATION-NUM	ELG00016	RACE-INFORMATION
ELG223	ELG.017.223	MSIS-IDENTIFICATION-NUM	ELG00017	DISABILITY-INFORMATION
ELG232	ELG.018.232	MSIS-IDENTIFICATION-NUM	ELG00018	1115A-DEMONSTRATION-INFORMATION
ELG241	ELG.020.241	MSIS-IDENTIFICATION-NUM	ELG00020	HCBS-CHRONIC-CONDITIONS-NON-HEALTH-HOME
ELG260	ELG.022.260	MSIS-IDENTIFICATION-NUM	ELG00022	ELG-IDENTIFIERS
TPL019	TPL.002.019	MSIS-IDENTIFICATION-NUM	TPL00002	TPL-MEDICAID-ELIGIBLE-PERSON-MAIN
TPL032	TPL.003.032	MSIS-IDENTIFICATION-NUM	TPL00003	TPL-MEDICAID-ELIGIBLE-PERSON-HEALTH-INSURANCE-COVERAGE-INFO
TPL066	TPL.005.066	MSIS-IDENTIFICATION-NUM	TPL00005	TPL-MEDICAID-ELIGIBLE-OTHER-THIRD-PARTY-COVERAGE-INFORMATION

Published Date	Data Guide Version	Data Element	Action	Field	Before	After
07/13/2023	3.10.0	ELG.021.251	UPDATE	Coding requirement	1. Mandatory2. For SSN States (i.e. SSN Indicator = 1), value must be equal to eligible individual's SSN3. For Non-SSN States (i.e. SSN Indicator = 0), value must not be equal to eligible individual's SSN4. Value must be 20 characters or less	1. Mandatory2. Value must be 20 characters or less
07/14/2023	3.10.0	ELG251	UPDATE	Data Dictionary	DE No\|DE Name\|Coding Requirement\| ELG251\|MSIS-IDENTIFICATION-NUM\|For SSN States (i.e. SSN Indicator = 1), value must be equal to eligible individual's SSN\|	DE No\|DE Name\|Coding Requirement\| ELG251\|MSIS-IDENTIFICATION-NUM\|\|
07/14/2023	3.10.0	ELG251	UPDATE	Data Dictionary	DE No\|DE Name\|Coding Requirement\| ELG251\|MSIS-IDENTIFICATION-NUM\|For Non-SSN States (i.e. SSN Indicator = 0), value must not be equal to eligible individual's SSN\|	DE No\|DE Name\|Coding Requirement\| ELG251\|MSIS-IDENTIFICATION-NUM\|\|